Health Promotion and Chronic Disease Prevention in Canada-Research Policy and Practice最新文献

The aim of this study was to provide an illustrative example of how researchers can effectively engage Black youth using a culturally responsive, participatory action research (PAR) approach. We aimed to examine the mental health needs of Black youth and identify culturally relevant strategies to increase access to and uptake of mental health services. The study took a PAR approach to foster maximum inclusion of youth in the research process. We collected data in two phases: (1) individual interviews with 30 youths; and (2) monthly conversation cafés over a four-month period with 99 youth participants. We recruited youth participants through the Africa Centre Youth Empowerment Group in Alberta, at a soccer tournament hosted by Africa Centre and through affiliated social networks, and established a youth advisory group that met quarterly and assisted with data collection, data analysis and dissemination. We shared our findings at a community engagement session for stakeholders. The study provided space for youth to share their experiences and to imagine solutions to their mental health difficulties; it also allowed us to conduct research that carefully integrated the perspectives of those most affected by the study's policy and practice recommendations. This project is an important case example that demonstrates promising practices and accessible methods across the data collection cycle, as well as the key ingredients and mechanisms that support culturally responsive practice.

Introduction: In 2018, in an effort to address the mental health inequities experienced by Black Canadians, the Government of Canada announced a CAD 10 million investment to establish the Public Health Agency of Canada's Promoting Health Equity: Mental Health of Black Canadians Fund (MHBC). The aim of this study was to examine and document the lessons learned from the MHBC, including successes and challenges.

Methods: Researchers conducted document analysis of 15 participating projects from 14 organizations' annual and final reports. Researchers then conducted interviews with representatives from nine of these organizations. An embedded case study design was used in the data collection and data analysis that included content analysis of annual and final reports, as well as thematic analysis of individual interviews.

Results: Analysis of the data from annual and final reports and interviews illuminated three main themes: facilitators of successes; challenges; and lessons learned and recommendations for funders. Facilitators included honorariums and incentives, participatory action research design and Black leadership. Challenges included delays (for obtaining ethics approval and program implementation); impacts of the COVID-19 pandemic; and difficulties maintaining partnerships. Finally, the lessons learned and recommendations that emerged for funders were that there is a need for longer term and more flexible funding, more Black representation and leadership within funding organizations and greater support of antiracist practices among mainstream service providers.

Conclusion: The findings of this study present the challenges and opportunities in supporting work aimed at improving the mental health and well-being of Black people in Canada.

Introduction: Health Promotion and Chronic Disease Prevention in Canada (the HPCDP Journal) is uniquely positioned to serve diverse audiences by presenting valuable contributions to the field of public health from scientists within and outside of government. The HPCDP Journal marking its 10th anniversary under the current name is an opportune time to reflect on how far the journal, the editorial team and the community of contributors have come.

Introduction: We investigated the prevalence of new or persistent manifestations experienced by COVID-19 survivors at 3 or more months after their initial infection, collectively known as post-COVID-19 condition (PCC).

Methods: We searched four electronic databases and major grey literature resources for prospective studies, systematic reviews, authoritative reports and population surveys. A random-effects meta-analysis pooled the prevalence data of 22 symptoms and outcomes. The GRADE approach was used to assess the certainty of evidence. PROSPERO CRD42021231476.

Results: Of 20 731 identified references, 194 met our inclusion criteria. These studies followed 483 531 individuals with confirmed COVID-19 diagnosis over periods of up to 2 years. Most focused on adults, nearly two-thirds were conducted in Europe and 63% were of high or moderate quality. The supplementary search identified 17 systematic reviews, five authoritative reports and four population surveys that reported on PCC prevalence. Our analysis revealed that more than half of COVID-19 survivors experienced one or more symptoms more than a year after their initial infection. The most common symptoms were fatiguedyspneamemory, sleep or concentration disturbances; depressionand pain. Limitation in returning to work was the most common outcome. Prevalence tended to be higher among females, individuals hospitalized during their initial infection and those who experienced severe COVID-19 illness.

Conclusion: PCC presents a significant health burden, affecting some groups more than others. This information will help inform health care system policies and services for people living with PCC and those caring for them.

Introduction: Traditional approaches to supporting older adults in adopting and maintaining an active lifestyle have largely failed. The previously proposed "Staircase Approach" offers a new foundation for developing interventions and public health strategies; this approach includes Step 1 (changing sedentary behaviour) and Steps 2 to 4 (incorporating more physical activity of increasing levels of intensity). In this systematic search and review, we aimed to inform the co-creation of a novel Staircase Approach intervention for community-dwelling, inactive older adults, primarily focussed on Step 1.

Methods: A systematic search was performed across six databases (MEDLINE, PsycInfo, CINAHL, Cochrane CENTRAL, SPORTDiscus and Scopus).

Results: After duplicates were removed, 3427 titles and abstracts were screened. Fourteen articles (including 17 intervention groups) were included after full-text review. Five were randomized controlled trials, three compared two interventions and six were single-arm studies. Sample sizes ranged from 9 to 176 participants, and included 617 older adults at baseline. Mean age of samples ranged from 64.3 (standard deviation [SD] 3.8) to 85.1 (SD 6.2) years, while the intervention length ranged from less than one day to 6 months. Sedentary time interventions are well accepted; most studies had completion rates above 80%. Based on findings from within-group comparisons, half of the studies showed a reduction in sedentary time (6/12 groups) and half showed an increase in physical activity (6/12 groups). Based on findings from between-group comparisons, 2 out of 5 intervention groups showed improvements in sitting time and physical activity outcomes compared to controls. Satisfaction and adherence to interventions were generally high.

Conclusion: Sedentary time interventions for older adults show promise and point to several components that may be included in an intervention focussed on Step 1 of the Staircase Approach.

Introduction: The 2023 Canadian Centre on Substance Use and Addiction drinking guidelines specify a universal low-risk threshold of 2 or fewer drinks per week, lower than previous guidelines that recommended no more than 10 drinks per week or 2 per occasion for females, and 15 per week or 3 per occasion for males. This study examined the increases in risk classification and perceptions of these new guideline thresholds.

Methods: Prevalence of those exceeding the new low-risk threshold was compared with that of previous and other international guidelines in an observational cohort of community adults (N = 1502) from southern Ontario who had been followed since 2018 (11 waves of data collection). To examine awareness of the new guidelines and perceived risk of drinking beyond them, a follow-up was conducted with a subset of the cohort, three months after the release of the guidelines (April 2023).

Results: Across waves, on average, 52% exceeded the new low-risk threshold compared to 11% who exceeded previous guidelines. Other international guidelines classified, on average, 16% (US), 20% (UK) and 29% (WHO) of the sample as exceeding low-risk guidelines. Approximately half of study participants (51%) were aware of Canada's new guidelines, but 77% perceived exceeding 2 drinks per week as having little to no risk.

Conclusion: Over four times more adults exceeded the new low-risk drinking threshold compared to that of the previous Canadian guidelines. Additionally, more were classified as exceeding the new low-risk threshold compared to other international drinking thresholds. These results, combined with low perceptions of risk associated with consuming more than 2 drinks per week, suggest that many Canadians are at risk of exceeding the new guidelines.

Executive summary: The drug toxicity crisis in Canada and elsewhere has increased the need for timely and relevant data to inform policies and programs aimed at mitigating substance-related harms. While a number of monitoring systems addressing specific components of substance use and related harms in Canada exist, they are not guided by an overarching conceptual framework. This evidence-informed policy brief describes the development of a conceptual framework for the public health monitoring of substance-related harms. The resulting framework includes four primary topic areas (risk and protective factors, substance use, health supporting systems and substance-related harms and benefits) four cross-cutting topic areas (life course, equity, substance use stigma and mental and physical health and illness) and two overarching considerations (respectful use of data and engagement). This framework can be used to organize existing activities and to identify data and monitoring gaps for further development.

Introduction: Healthcare workers (HCWs) have reported COVID-19 pandemic-related adverse mental health impacts. We examined the demographic profile of HCWs who self-referred for mental health treatment, how referrals changed over time in relation to waves of COVID-19, what the main problem was for which HCWs sought treatment, and how this changed during the pandemic.

Methods: Five major healthcare institutions provided mental health supports to HCWs across Ontario during the pandemic. Data from May 2020 to March 2022 were collected from 2725 HCW self-referrals regarding referral frequency, main presenting mental health problem and demographic information including ethnicity, gender, age, healthcare setting, profession and whether the HCW had a prior mental health diagnosis or had received prior mental health treatment.

Results: Treatment-seeking HCWs who self-referred predominantly self-identified as female and White. Almost half were nurses, and almost half had received previous mental health treatment; a slightly higher percentage reported a prior mental health diagnosis. Over 60% of the overall sample of HCWs worked in hospitals. The timing of increases and decreases in monthly new referrals roughly aligned with the onset and ending, respectively, of COVID-19 waves. The top five most common presenting problems for treatment-seeking were generalized anxiety/worry symptoms, depression, situational crisis/acute stress response, difficulty with stress/occupational or financial, and posttraumatic stress symptoms.

Conclusion: Ontario HCWs self-referred to access mental health supports during the COVID-19 pandemic. The majority sought treatment for generalized anxiety/worry or depression symptoms. Results of this study may inform system planning for future pandemics, as well as for HCW wellness programs for continued workplace stress in the postpandemic period.

Introduction: This study provides a descriptive overview of the prevalence of posttraumatic stress disorder (PTSD) in Canada, across sociodemographic characteristics, mental health-related variables and negative impacts of the COVID-19 pandemic.

Methods: Data were obtained from cycles 1 and 2 of the Survey on COVID-19 and Mental Health (SCMH), collected in fall 2020 (N = 14 689) and spring 2021 (N = 8032). The prevalence of PTSD was measured using the PTSD Checklist for DSM-5 (PCL-5) Cross-sectional associations were quantified using logistic regression, while controlling for sociodemographic characteristics.

Results: The overall prevalence of PTSD was 6.9%. Factors associated with higher PTSD prevalence were female gender; younger age; lower income (females only); living in an urban area; frontline worker status or not being at work in the past week (males only); fair or poor mental health; a weak sense of community belonging; symptoms of generalized anxiety disorder and major depressive disorder; suicidal ideation; heavy alcohol use; daily cannabis use; increased alcohol and cannabis use since the start of the pandemic; decreased alcohol consumption since the start of the pandemic (males only); concerns about violence in the home; and negative impacts of the pandemic.

Conclusion: PTSD prevalence in Canada varies significantly across sociodemographic groups and is more common among those with indicators of lower mental health and well-being, as well as those more adversely affected by the COVID-19 pandemic. Ongoing and enhanced surveillance of PTSD in Canada is important to better understand and address the burden and impacts of this condition.